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Physician Personal and Professional Sense of Self

May 19, 2017

By Tom Janisse, MD

Introduction

What do physicians do to most satisfy their patients? And how do they maintain a state of well-being in their clinical practice? The answers to these questions and others have unfolded over several years in a series of confidential interviews I’ve done with physicians who rate highest on the post-visit patient satisfaction survey.

The area of physician well-being was an important component of my research interest, and some of the following has been previously published in The Permanente Journal.* I believe these statements speak for themselves.

The third in a series

This article is the third post in a series of five detailing, through verbatim Northwest Permanente physician voices, how physicians value and experience patient interactions as part of their medical practice. The five installments are:

  1. What physicians derive from patient interactions
  2. Physician awareness of their state of well-being
  3. Physician personal and professional sense of self
  4. The effect of physician well-being on patient interactions
  5. Physician self-care practices.

The actual question posed to the physicians was:

Do you feel that your sense of well-being as a doctor is related to how you practice medicine with your patients?

All physicians agreed that how they practice medicine with their patients is related to, and improves, their own sense of well-being.

Physician personal and professional sense of self

“Yes, I certainly do derive a sense of well-being from patient interactions. I have a bad evening at home or in the morning, and I’ll go to work and see several patients and have a good interaction — it changes my whole outlook on life. It really is important. In general, my home life is wonderful, but it can be completely turned around by experiences at work, good or bad, actually. My interaction with patients is very gratifying. However, the environment in which I’m having to do it is getting harder and harder to deal with, because the pressure is on me to see more people, or to do the coding, or the electronic medical record, or one more little thing that ‘doesn’t take any time.’ It takes away from my time with my patients and that upsets me. I’ve avoided committees and other things that physicians use to dilute patient care a bit. As a result, I have more patients than I can take care of. I need to balance that out. My overall sense of well-being is fine, but I’m getting kind of tired of being interrupted.” (General Surgeon)

“I have the luxury of being a subspecialist where I get to focus on one aspect of a patient’s health, rather than having to simultaneously manage a number of chronic conditions for which there may not be a great answer. And I have the luxury of having a diagnosis for which there is a good treatment. A happy patient makes for a happy doctor. I think that part of the reason for my successful relationships with patients is due to the success of the treatment. I do feel very fortunate from a professional standpoint that this is what I do for a living, because I do feel rewarded, and I do think that my emotional and mental well-being as a physician couldn’t really be higher from a mental standpoint.” (Orthopedist)

“Very important, because I know that at times when I am distracted I find it very difficult to be present, very difficult to invest and to have that expression of love that I was talking about. It’s not impossible and very often if you just successfully let go of your own problems when you walk into the room, you actually recognize that you feel better. Actually done right, the process is good for you because letting go often is part of the first step of what it means to be well. Because a lot of what it is to not be well is stuff we choose to hold on to and we don’t really have to. (Oncologist)

*Janisse, T. Relationship of a physician’s well-being to interactions with patients: practices of the highest performing physicians on the Art of Medicine patient survey, 
Perm J 2008 Fall:12(4):70-6. DOI: http://dx.doi.org/10.7812/TPP/08-041.

Tom Janisse, MD, is editor and publisher of The Permanente Journal and The Permanente Press.

 

 

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